Molly's chemo treatment schedule (abandoned in maintenance cycle 7/8 due to relapse)

Molly's Low-Risk ALL chemo treatment schedule (Protocol AALL1331)
(may differ from other ALL patient's treatment schedules)

• DONE! First phase: Remission Induction. The goal of induction therapy is to bring the disease into remission. Remission is when the patient's blood counts return to normal and bone marrow samples show no sign of disease. 4 weeks long.
  
  • 2x/day chemo steroids by mouth (dexamethasone or DECADRON) (Side effects: increased appetite, insomnia, irritability, water retention in face and other possible areas of body, weakness, increased stomach acid)
  • 2x/day antacid by mouth (ranitidine or ZANTAC) (Side effects: no common side effects)
  • 2x/day on Mon and Tue preventative antibiotic for pneumonia by mouth (trimethoprim and sulfamethoxazole or SEPTRA) (Side effects: no common side effects)
  • 1x/week chemo drug through the port implant (vincristine or ONCOVIN) (Side effects: hair loss)
  • 1x/phase chemo drug through the port implant (pegaspargase or PEG L-asparaginase) (Side effects: nausea, weakness, poor appetite, stomach pain)

• DONE! Second phase: Consolidation. The goal of consolidation therapy is to reduce the number of disease cells left in the body. The drugs and doses used during consolidation therapy depend on the patient's risk factors. 4 weeks long.
  
  • 1x/day chemo drug by mouth (mercaptopurine or PURINETHOL) (Side effects: low blood counts, possible liver damage)  
  • 1x/phase chemo drug through the port implant (vincristine or ONCOVIN) (Side effects: hair loss)

• DONE! Third phase: Interim Maintenance I 4 weeks delayed because of RSV. 8 weeks long.
  • 5x/phase (10 days apart) chemo drug through the port implant (methotrexate or (TREXALL) (Side effects: low blood counts, nausea, mouth sores, poor appetite) 
  • 5x/phase (10 days apart) chemo drug through the port implant (vincristine or ONCOVIN) (Side effects: hair loss)

• DONE! Fourth phase: Delayed Intensification 8 weeks long.
  • 2x/day on days 1-7 and 15-21 chemo steroids by mouth (dexamethasone or DECADRON) (Side effects: increased appetite, insomnia, irritability, water retention in face and other possible areas of body, weakness, increased stomach acid)
  • 3x/phase chemo drug through the port implant (vincristine or ONCOVIN) (Side effects: hair loss)
  • 3x/phase chemo drug through the port implant (doxorubicin or RUBEX) (Side effects: low blood counts, nausea, mouth sores, hair loss)
  • 1x/phase chemo drug through the port implant (pegaspargase or PEG L-asparaginase) (Side effects: nausea, weakness, poor appetite, stomach pain)
  • 1x/phase chemo drug through the port implant (cyclophosphamide or CYTOXAN) (Side effects: low blood counts, nausea, hair loss, loss of fertility, poor appetite)
  • 1x/day on days 29-42 chemo drug by mouth (thioguanine or 6-TG) (Side effects: nausea, low blood counts, poor appetite)
  • 1x/day on days 29-32 and 36-39 through the port implant (cytarabine or CYTOSAR-U) (Side effects: low blood counts, nausea, mouth sores)

• DONE! Fifth phase: Interim Maintenance II 8 weeks long.
  
  • 5x/phase (10 days apart) chemo drug through the port implant (methotrexate or TREXALL) (Side effects: low blood counts, nausea, mouth sores, poor appetite) 
  • 5x/phase (10 days apart) chemo drug through the port implant (vincristine or ONCOVIN) (Side effects: hair loss)

•  RELAPSED IN 7TH CYCLE Sixth phase: Final Maintenance. If a patient stays in remission after induction, consolidation, interim maintenance and delayed intensification therapies, maintenance therapy begins. The goal is to destroy any disease cells that remain so that the leukemia is completely gone. 12 weeks long, 8 cycles.
  
  • 1x/day chemo drug by mouth (mercaptopurine or PURINETHOL) (Side effects: low blood counts, possible liver damage)
  • 1x/phase chemo drug through the port implant (vincristine or ONCOVIN) (Side effects: hair loss)
  • 2x/day on days 1-5 chemo steroids by mouth (dexamethasone or DECADRON) (Side effects: increased appetite, insomnia, irritability, water retention in face and other possible areas of body, weakness, increased stomach acid)
  • 1x/week chemo drug by mouth (methotrexate or TREXALL) (Side effects: low blood counts, nausea, mouth sores, poor appetite)

• Ongoing treatment: Central Nervous System (CNS) Prophylaxis Chemotherapy. During all three phases of chemotherapy treatment, many patients receive extra chemotherapy to destroy leukemia cells that may have spread to the central nervous system (the brain and spinal cord). This chemotherapy is injected right into the spinal fluid using a lumbar puncture (spinal tap) or an Omaya reservoir (a device placed under the scalp). It is called intrathecal chemotherapy.
  
  • DONE! Day 1 and 8 of Induction - lumbar puncture and chemotherapy administration (methotrexate or TREXALL) (Side effects: low blood counts, nausea, mouth sores, poor appetite)
  • DONE! Day 1, 8, and 15 of Consolidation - lumbar puncture and chemotherapy administration (methotrexate or TREXALL) (Side effects: low blood counts, nausea, mouth sores, poor appetite) 
  • DONE! Day 31 of Interim Maintenance I - lumbar puncture and chemotherapy administration (methotrexate or TREXALL) (Side effects: low blood counts, nausea, mouth sores, poor appetite) 
  • DONE! Day 1 and 29 of Delayed Instensification - lumbar puncture and chemotherapy administration (methotrexate or TREXALL) (Side effects: low blood counts, nausea, mouth sores, poor appetite) 
  • DONE! Day 1 and 31 of Interim Maintenance II - lumbar puncture and chemotherapy administration (methotrexate or TREXALL) (Side effects: low blood counts, nausea, mouth sores, poor appetite) 
  • RELAPSED IN 7TH CYCLE Day 1 in each 12 week cycle of Final Maintenance - lumbar puncture and chemotherapy administration (methotrexate or TREXALL) (Side effects: low blood counts, nausea, mouth sores, poor appetite)